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Perio - Exam 2 > Utah Systemic Disease - Part II > Flashcards

Utah Systemic Disease - Part II Flashcards

1
Q

What are the direct effects of bacteria and bacterial products?

A

Release IL-1, IL-6, TNF-alpha

Result in vascular lesions

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2
Q

What are the indirect effects of bacteria and bacterial products?

A

Stimulate liver

Release CRP, fibrinogen, lipid abnormalities, coagulation factors

Result in vascular lesion

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3
Q

What are two well-established risk factors for cardiovascular disease?

A

Tobacco smoking

High LDL

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4
Q

T/F - CRP is an important risk factor for MI.

A

TRUE

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5
Q

What two things are there a relationship with cardiovascular disease?

A

CRP

Plasma fibrinogen

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6
Q

T/F - Periodontitis increased systemic CRP and fibrinogen.

A

TRUE

CRP levels increased in periodontitis

One year perio tx show a reduction of CRP

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7
Q

Atherosclerotic plaques pathogenesis include what 5 things?

A

Endothelial damage/dysfunction

Lipid deposition and oxidation in the sub-endo space

Macrophage/PMN chemotaxis

Smooth muscle proliferation

Plaque rupture

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8
Q

Where is CRP created?

A

By hepatocytes

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9
Q

T/F - People over age 16 have some atherosclerosis.

A

TRUE

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10
Q

Look at slide 9

A

Slide 9

It’s a chart

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11
Q

What is MCP1?

A

Monocyte chemotactic protein-1

—Member of the small inducible gene (SIG) family

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12
Q

What does MCP1 do?

A

Recruits monocytes to sites of injury and infection

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13
Q

Where is the gene for MCP1?

A

On chromosome 17

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14
Q

Where is MCP1 found?

A

In the jts of people with RA

Elevated in urine as a sign of kidney inflammation

Associated with diabetes

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15
Q

T/F - Macrophages express receptors that take up modified LDL.

A

TRUE

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16
Q

T/F - TNFalpha, IL-6, and IL-1 are also associated with chromosome 17 at the same locus (17q11.2-q12).

A

TRUE

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17
Q

Slides 12-14

A

Pictures

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18
Q

T/F - Macrophages and foam cells express growth factors and proteinases.

A

TRUE

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19
Q

The remnants of _______ and ________ are also proinflammatory.

A

VLDL

Chylomicrons

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20
Q

Plaque inflammation causes what 3 things?

A

Fibrous cap thinning

Plaque rupture

Thrombosis

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21
Q

Breakdown of plaque leads to what 4 things?

A

MI

Angina

Stroke

TIAs

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22
Q

T/F - Periodontitis has a role in atherosclerosis.

A

TRUE

23
Q

Stimulation of cells with LPS, TNFalpha, and IL-1beta induces what?

A

NFkappaB

24
Q

_________ stimulates macrophage activation and smooth muscle cell proliferation.

A

NFkappaB

25
Q

Doxycycline does what?

A

Reduces CRP and fibrinogen to normal levels

26
Q

Preventative maintenance therapy is aimed at reducing which bacteria?

A

P gingivalis

27
Q

Minocycline does what for pts with increased risk of CVD?

A

Reduced CRP and TNFalpha

28
Q

Do oral bacteria have a relationship to CVD?

A

YES

Directly increase risk for CVD and strokes

29
Q

T/F - Poor dental health is associated with CVD.

We can’t clearly say though that severe periodontal disease will give you an MI.

A

TRUE

30
Q

T/F - T forsynthesis and P gingivalis are assocaited with MI.

A

TRUE

31
Q

T/F - There is an associated of periodontal disease and increased risk for CVD.

A

TRUE

32
Q

T/F - Periodontitis is related to atherosclerosis.

A

TRUE

33
Q

What are the 2 types of stroke?

A

Hemorrhagic

  • Bleeding into brain
  • Death is typically imminent
  • NOT associated with periodontal disease

Nonhemorrhagic/ischemic

  • Caused by blockage of a bv supplying the brain
  • IS associated with periodontal disease
34
Q

What should we do with CVD pts?

A

Conduct medical history and physical exam

ID physical signs and symptoms of cardiac dysfunction

Evaluate vital signs

Seek medical consultation when indicated

Know concomitant

Know conditions req ax prophylaxis

35
Q

T/F - In men less than 50 yo, 25% fo pts who had a stroke had significant dental disease.

A

TRUE

36
Q

T/F - Periodontal disease is a significant risk factor for non-hemorrhagic but not for hemorrhagic stroke.

A

TRUE

37
Q

T/F - Only strokes associated with narrowing of the arteries (atherosclerosis) seem to be related.

A

TRUE

38
Q

T/F - Estrogen and progesterone can be used by some bacteroides spp (G-), and P intermedia as substitutes for vitamin K, one of their important growth factors.

A

TRUE

39
Q

T/F - Use of contraceptives also use gestational hormones that can also lead to increased gingival inflammation.

A

TRUE

40
Q

T/F - Pregnant women have more gingivitis independent of plaque accumulation.

A

TRUE

It mirrors increasing estrogen and progesterone levels in months 4-9

This is reversible

Hormones are at high levels in the GCF

41
Q

CT breakdown may be enhanced by ________ ________ activating the fibrinolytic system.

A

Plasminogen activator

42
Q

Preterm birth occurs at what rate in the US?

A

1 in 8

Inflammation thought to account for 30-50% of all premature deliveries

43
Q

More than ___% of babies in the US are born at a low birth weight.

A

8

44
Q

What is leukocyte adhesion deficiency (LAD) due to?

A

Deficiency in cell surface integrins

45
Q

Tell me about LAD.

A

Leukocytes cannot adhere to wall of endothelium at sites of infection
-No diapedesis or migration from capillaries into soft tissue

No migration to infectious site

Leads to death

46
Q

T/F - Chediak-Higashi syndrome is related to an increased risk of periodontal disease.

A

TRUE

47
Q

What is cyclic neutropenia?

A

Cyclical decrease in PMNs on a 21 day cycle and a 3-10 day period of severe neutropenia

3-6 days of fever, malaise, mood swing, oral ulcerations

Periodontitis may progress faster during PMN depression

48
Q

Cyclic vs congenital neutropenia.

A

Cyclic - Due to genetics

Congenital - Present at Birth

49
Q

Tell me about congenital neutropenia.

A

Low PMN count

Severe bacterial infections

50
Q

Just remember that neutropenia, LAD, Chediak-Higashi Syndrome, Papillon-Lefevre Syndrome are systemic conditions that increase periodontitis.

A

Good

51
Q

Tell me about Down syndrome in regards to perio.

A

PMNs normal

Chemotaxis, phagocytosis, and intracellular killing may be reduced

Collagenase and GCF PMNs may be increased

More at risk for periodontal disease

52
Q

T/F - Sometimes the first sing of leukemia is seen in the oral cavity.

A

TRUE

Mucosal ulcerations and gingival enlargements

53
Q

Tell me about Wegener’s Granulomatosis (Strawberry gingivitis).

A

Necrotizing vasculitis of small vessels of upper and lower respiratory tract

Hyperplastic gingivitis

Tooth mobility and tooth loss

54
Q

Quiz Stuff for next week

PD (Periodontal disease) is inflammatory disease, associated with microbial flora

Increase in CRP, plasmin activators

if get health, lower those mediators

Inflammatory mediators have direct effect on systemic plaques, so increases risk of thrombosis

PD and CVD are related based on populations, looking at an individual, we can’t always assume that

Pregnant women are at an increased risk for gingivitis

Systemic diseases can cause periodontal disease, decrease PMN fx or decreased chemotaxis

Downs is at risk for PD

A

KNOW THESE

Perio - Exam 2 (8 decks)

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